Glottic insufficiency is a medical term used to describe insufficient closure of the glottis (i.e., the vocal folds and the space between the folds) during phonation, leading to poor voice quality and “breathiness” during phonation. Non-limiting examples of disorders that are common causes of glottic insufficiency include unilateral vocal fold paralysis, vocal fold paresis, and presbylaryngis. Typically, in each of these disorders, at least one of the vocal folds does not medialize to a normal medial position during phonation, which leads to the insufficient glottic closure.
In certain cases of glottic insufficiency, treatment is primarily surgical and aims to medialize one of the vocal folds (e.g., a paralyzed vocal fold). Current treatments include injection laryngoplasty, medialization thyroplasty with insertion of a Silastic, Gore-tex, or titanium implant, and arytenoid adduction. While injection laryngoplasty is a simple procedure which can be performed within the office, it is believed that injection laryngoplasty cannot correct severe cases of paralysis. It is also believed that injection laryngoplasty can negatively impact the mucosal wave, decreasing post-treatment voice quality. Moreover, it is believed that current implants are inhibited by several key factors: an inability to easily modify the implant according to individual patient anatomy; an inability to adjust the degree of medialization post-operatively; and potential extrusion into the airway (i.e., trachea).